Progressive Multifocal Leukoencephalopathy Misdiagnosed as Neuropsychiatric Systemic Lupus Erythematosus With a Catastrophic Outcome.

Autor:	Algahtani H; King Abdulaziz Medical City.; Department of Neuroscience, King Faisal Specialist Hospital & Research Centre.; College of Medicine, King Saud bin Abdulaziz University for Health Sciences., Shirah B; Department of Neuroscience, King Faisal Specialist Hospital & Research Centre., Othman L; Department of Neuroscience, King Faisal Specialist Hospital & Research Centre.; College of Medicine, King Saud bin Abdulaziz University for Health Sciences., Almarri AK; Ibn Sina National College, Jeddah., Alwafi E; King Abdulaziz Medical City.; Department of Neuroscience, King Faisal Specialist Hospital & Research Centre.; College of Medicine, King Saud bin Abdulaziz University for Health Sciences., Alassiri AH; Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City.; College of Medicine, King Saud bin Abdulaziz University for Health Sciences.; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Jazyk:	angličtina
Zdroj:	The neurologist [Neurologist] 2022 Sep 01; Vol. 27 (5), pp. 271-275. Date of Electronic Publication: 2022 Sep 01.
DOI:	10.1097/NRL.0000000000000398
Abstrakt:	Introduction: Progressive multifocal leukoencephalopathy (PML) is a rare infection of the central nervous system due to the reactivation of the John Cunningham polyomavirus. It is commonly a progressive fatal disease with worldwide distribution. Case Report: We describe a rare case of PML, which was misdiagnosed as neuropsychiatric systemic lupus erythematosus (SLE) with a catastrophic outcome due to delay in diagnosis with superadded cyclophosphamide therapy. Conclusion: There are several lessons taught from our case. Firstly, in patients with autoimmune disorders who are strongly immunosuppressed, the new onset of cognitive impairment and seizures should alert the treating physician to look carefully for PML. Secondly, in cases of SLE where the diagnosis of the cause of cognitive impairment and seizures is not clear, we suggest that immunosuppression should not be intensified until PML has clearly been ruled out. Lastly, multidisciplinary care in patients with suspected neuropsychiatric SLE including a neurologist, an infectious diseases consultant, a neuroradiologist, and a rheumatologist is needed. Competing Interests: The authors declare no conflict of interest. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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